Customer Service Representative – Workers Compensation Claims

About the role

This hybrid position supports specialized workers‑compensation insurance claims with a strong emphasis on customer service. You will manage claims from first notification through closure while collaborating with cross‑functional teams and maintaining high accuracy.

Key responsibilities

• Manage end‑to‑end workers‑compensation claims, ensuring accurate documentation and timely resolution.
• Coordinate with policyholders, claimants, medical providers, and internal teams to gather and clarify claim information.
• Evaluate claim data, coverage terms, and supporting documents to determine compensability.
• Document all claim activities, conversations, and decisions in the claim management system.
• Communicate claim status, next steps, and timelines to customers with empathy and clarity.
• Collaborate with medical case managers to review treatment plans and return‑to‑work options.
• Analyze claim trends and payment patterns to identify process‑improvement opportunities.
• Adhere to workers‑compensation regulations and internal compliance guidelines.
• Respond promptly to customer inquiries via phone, email, or digital channels.
• Utilize claim‑management tools and dashboards to track workload and meet service‑level agreements.
• Support rotational shift coverage and ensure seamless handover of pending tasks.

Required profile

• 2–3 years of hands‑on experience handling workers‑compensation insurance claims.
• Strong customer‑service orientation with active listening and clear communication.
• Ability to manage difficult conversations and maintain professionalism.
• Flexibility to work rotational shifts and collaborate with cross‑functional teams.

Required skills

What we offer

• Hybrid work environment with rotational shift flexibility.
• Opportunities to contribute to continuous‑improvement initiatives.
• Exposure to a dynamic insurance claims portfolio.